Healthcare Provider Details

I. General information

NPI: 1346267333
Provider Name (Legal Business Name): KURT A HOFFERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 GROVE RD GMH ER ADMINISTRATION
GREENVILLE SC
29605-5611
US

IV. Provider business mailing address

255 ENTERPRISE BLVD SUITE 250
GREENVILLE SC
29615-6300
US

V. Phone/Fax

Practice location:
  • Phone: 864-455-6372
  • Fax:
Mailing address:
  • Phone: 864-454-0888
  • Fax: 864-454-1130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number21889
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: